Filling the gap

Through a charity founded by ADA NSW, Filling the Gap, volunteer dental professionals are changing the lives of society’s most vulnerable patients. Cameron Cooper reports

Dr Andrew Dean has fitted many sets of dentures during his career, but one recent patient case will always stand out for him.

In his role as a volunteer dentist assisting underprivileged members of society at special clinics in Sydney, he completed a denture treatment for a woman who had not had proper teeth for a decade then showed her the results in a mirror.

“She was crying—in a good way—and I had a few tears, too,” says Scottish-born Dr Dean, who now works at Pacific Smiles Dental at Gladesville in Sydney. “That’s the sort of satisfaction you can get as a volunteer. And it’s priceless.”

Dr Dean, who in the past has trained Tanzanian healthcare workers in dental-extraction techniques through British charity Bridge2Aid, is one of a growing number of dental professionals who are providing free oral care treatments to vulnerable members of the community. The list includes asylum-seekers, the homeless, domestic violence victims, the mentally ill and those recovering from addiction.

Missing out

In a Grattan Institute report titled ‘Filling the gap: A universal dental scheme for Australia’, researchers advocated a Medicare-style system for primary dental care. They estimated that about two million Australians who required dental care in the past year either did not get it or delayed getting it because of cost. The poor and disadvantaged are most likely to miss out on care.

In this environment, volunteer dentists and dental assistants are stepping into the breach. One initiative that is making a difference is Filling the Gap, a charity established by the NSW branch of the Australian Dental Association that is committed to improving the health and lives of vulnerable people through the provision of pro bono dental aid programs. The aim is to bring more structure and efficiency to volunteering services that in the past have been quite ad hoc.

“By formalising it into its own charity and its own identity, we can do much more,” says Kate Miranda, general manager of Filling the Gap.

The charity prioritises those most in need who are unable to access mainstream dental services. Patients cannot access services directly—they must be referred through one of about 20 partner charities.

The burden of oral disease is greatest among those who are socially disadvantaged. There are even greater barriers to accessing oral health care for those who have chronic health conditions.

Kate Miranda, general manager, Filling the Gap

Miranda expects that the service will run 12 dental aid clinics in Sydney next year, including at the ADA NSW’s own clinic at its headquarters in St Leonards, Sydney. Dentists are also encouraged to provide oral care services at their private clinics for eligible patients.

Miranda says in the past 12 months Filling the Gap had about 70 volunteer dentists and dental assistants who provided more than 500 appointments offering dental treatment worth more than $320,000.

“The burden of oral disease is greatest among those who are socially disadvantaged,” she says. “There are even greater barriers to accessing oral health care for those who have chronic health conditions. Poor oral health affects a person’s quality of life, ability to work, socialise, communicate, smile and kiss. It impacts confidence and self-esteem.”

Dentists benefit too

In Tamworth, NSW, Dr Michael Jonas is doing his bit as a volunteer. The chair of Filling the Gap originally observed Red Cross dental programs for the disadvantaged, which fanned his desire to volunteer.

“They were always the people who’d fallen through the gaps,” he says.

While the main benefactors of pro bono dental services are the patients, Dr Jonas says the benefits for participating dentists are also significant.

“You’re out there looking after the oral health care needs of people for no other reason except that you can. It gives a great sense of pride.”

According to Dr Jonas, volunteering also engenders a sense of collegiality between participating dentists who “get a sense of being part of something that is much bigger than a typical dental surgery”.

Recently in Tamworth, Dr Jonas treated refugees from Myanmar, noting that they were “unbelievably stoic and amazingly appreciative. It was a very humbling experience, indeed.”

You’re out there looking after the oral health care needs of people for no other reason except that you can. It gives a great sense of pride.

Dr Michael Jonas, chair, Filling the Gap

Filling the Gap is volunteer-led in so much as there are no policies around how much time dental professionals must commit to the program. Dr Dean says this flexibility means volunteering is viable for all dentists who are willing to offer their support but who are inevitably stretched for time.

Although he admits to having had initial concerns about the patient profiles of people who may have been abusing drugs or alcohol, Dr Dean says he has had no issues with any patients.

“You just need to have an open mind about treating some of the most interesting characters you’ll meet.”

Recruitment drive

“We’re not talking about orthodontics, implants, chrome dentures—it’s really about getting people’s mouths to function the way they should.”

As it enters the new year, Filling the Gap plans to ramp up its services and bring on board more dentists and dental assistants. Miranda takes heart from the many positive stories she hears from volunteer dentists and their patients.

“We hear people say the dentist listened to me and got me out of pain. A lot of people have had their teeth ravaged by drug use and, if they’re taking that final step towards re-joining society and getting their confidence back, an important step is fixing their oral health. It’s about being able to look at the world and smile.”

She encourages more dentists and dental assistants to volunteer.

“We get all sorts of volunteers, but the one thing that’s universal across all the volunteers is that they want to make a difference. They have a lot of expertise and they realise that the mouth is the one part of our health system that is not supported by government funding. So this is their way of giving back.”